Headache resident survival guide
A headache is pain or discomfort in the head, scalp, or neck.
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Brain abscess
- Cerebral aneurysm
- Hypertensive encephalopathy
- Increased intracranial pressure
- Intracerebral hemorrhage
- Subarachnoid hemorrhage
- Subdural hemorrhage
Shown below is an algorithm summarizing the approach to Headache.
|Detailed Hx: Characteristics of headache, Frequency, intensity, duration, site, radiation, change in vision, recent trauma, changes in sleep, exercise, weight, or diet.Change in work or lifestyle, Change in method of birth control, Effects of menstrual cycle.Fever, Malaise, Lethargy, Purpuric rash, Neck stiffness, Photophobia, Precipitating and relieving factors, Relationship with food/alcohol. Assess functional impairment, ROS to rule out systemic illness. Family history of migraines, Medications history, Social history|
|Obtain Blood pressure and Pulse. Listen for bruit. Palpate the head, neck, and shoulder. Check temporal and neck arteries. Examine the spine and neck muscles. Functional neurologic examination. Look for Neck stiffness, skin rash|